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Organization
KERSENBROCK DENTAL CARE LLC
Active
Organization
KERSENBROCK DENTAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAURICE JOHN KERSENBROCK DDS (PRESIDENT)
(402) 336-4211
Entity
Organization
Contact information
Practice address
430 E. EVERETT ST., O'NEILL, NE 68763-1838
(402) 336-4211
(402) 336-3905
Mailing address
PO BOX 189, O'NEILL, NE 68763-0189
(402) 336-4211
(402) 336-3905
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4971
NE
1223G0001X
General Practice Dentistry
6903
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025832300
—
NE
Enumeration date
05/16/2012
Last updated
06/25/2012
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